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Oral health programme in SG reduces childhood caries among infants, toddlers

Stephen Padilla
28 Feb 2018
For pearly whites, perhaps it is time to rethink some of the conventional wisdom about oral hygiene

The 2-year preventive oral health programme in Singapore has succeeded in lowering the presence of severe early childhood caries (SECC) among infants and toddlers, driven primarily by the implementation of targeted behaviour modifications, such as reducing the consumption of sweetened milk and increased use of fluoridated toothpaste, reports a study.

“The result of this exploratory study provides preliminary clinical evidence for the training and allocation of manpower and the distribution of monetary resources for early caries prevention in children,” researchers said.

“It provides the basis for collaboration with medical and early childhood professionals, as well as the development of an infant oral health programme that can be tailored to the local population,” they added.

A total of 90 children and their caregivers participated in the programme, and 64 children, who were 24 months older than the intervention group at the initial visit, were enlisted as controls in a quasi-experimental study design. SECC presence and d3mfs were assessed in the control group at initial visit and the intervention group after completion of the 2-year programme.

SECC was present in some children in the intervention (7.8 percent) and control (31.3 percent) groups (difference, 23.5 percent; 95 percent CI, 11–36 percent; p<0.001). A greater proportion of participants in the intervention group (91.1 percent) had d3mfs = 0 and habits associated with low risk for caries compared with those in the control group (84.4 percent). [Singapore Med J 2018;59:87-93]

Severity of dental caries was greater among controls vs those in the intervention group, with a higher percentage of children having d3mfs >5. The odds of having SECC were three times higher in the control group than in the intervention group, and the effect remained significant (p=0.037) even after adjusting for other significant risk factors.

“A 12-month cohort study of Singaporean preschool children reported a caries incidence of 44 percent, as compared to our finding of 31.3 percent in the control group,” researchers said. “In contrast, the 24-month caries incidence of 7.8 percent in our intervention group was significantly lower.”

These findings showing the success of the preventive oral health programme in reducing SECC support those of previous studies. [Clin Oral Investig 1998;2:137-142; Int J Paediatr Dent 2001;11:117-122; Acta Odontol Scand 2005;63:163-167; J Paediatr Child Health 2011;47:367-372; Eur J Public Health 2014;24:893-898; J Dent Child (Chic) 2003;70:231-234; J Am Dent Assoc 2004;135:731-738]

This success is partly due to the maintenance of good oral hygiene practices and fewer high caries risk habits among children in the intervention group, according to researchers.

“Dental caries, which is prevalent in Singapore preschoolers, is a disease that has a major impact on children’s health and places a high cost on the society and health services,” researchers said. “Oral health programmes for young children implemented in some parts of the world have been shown to be effective in the prevention of dental caries.”

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